Pong Mei Yin, Yap Jun Fai, Sim Hong Guan, Lee Kee Wei, Suhaimi Anwar
Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Training Management Division, Ministry of Health, Putrajaya, Malaysia.
Pan Afr Med J. 2024 Nov 11;49:72. doi: 10.11604/pamj.2024.49.72.45624. eCollection 2024.
Acute stroke occurring during cardiac catheterization is an extremely uncommon procedural complication. There is a significant research gap in the published literature regarding the occurrence of acute ischemic stroke during percutaneous coronary intervention in Asian populations, with most data originating from western countries, underscoring the need for localized studies to develop tailored detection and management strategies. We present the case of a 70-year-old Indian woman with multiple cardiovascular risk factors who experienced an acute ischemic stroke while undergoing percutaneous coronary intervention in Malaysia. We hypothesized that the clinically relevant cerebral infarction might have originated from large plaques located along the aortic arch. Catheterization-related strokes caused by embolization of fresh thrombi forming at the catheter or guidewire tips should be thrombolysed. Choosing the transradial approach reduces stroke risk but requires careful use of appropriately sized instruments and meticulous handling of guidewires to ensure patient safety.
心脏导管插入术期间发生的急性中风是一种极其罕见的手术并发症。在已发表的文献中，关于亚洲人群经皮冠状动脉介入治疗期间急性缺血性中风的发生存在重大研究空白，大多数数据来自西方国家，这凸显了开展本地化研究以制定针对性检测和管理策略的必要性。我们报告了一名70岁的印度女性病例，她有多种心血管危险因素，在马来西亚接受经皮冠状动脉介入治疗时发生了急性缺血性中风。我们推测，临床上相关的脑梗死可能源于沿主动脉弓的大斑块。由导管或导丝尖端形成的新鲜血栓栓塞引起的与导管插入术相关的中风应进行溶栓治疗。选择经桡动脉途径可降低中风风险，但需要谨慎使用尺寸合适的器械并精心操作导丝以确保患者安全。
